Active NPI
Susie Burns, LMT, NKT
- Massage Therapist
- Bend, OR
National Provider Identifier
1245536465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 16722
- Practice address
- 369 NE Revere Ave
Suite B
Bend, OR 97701-4059 - Phone
- (541) 550-6680
- NPI assigned
- Feb 4, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 16722 | OR | Primary |
| Kinesiotherapist | 226300000X | 16722 | OR |
Addresses
Primary practice location
369 NE Revere Ave
Suite B
Bend, OR 97701-4059
Mailing address
369 NE Revere Ave
Suite B
Bend, OR 97701-4059
Phone (541) 550-6680
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 836868 | Other | OR | ASSOCIATED BODYWORK & MASSAGE PEOFESSIONALS |
| 16722 | Other | OR | OREGON BOARD OF MASSAGE THERAPISTS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16722 | OR | MD | Kinesiotherapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297555200000",
"number": "1245536465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "369 NE REVERE AVE",
"address_2": "SUITE B",
"city": "BEND",
"state": "OR",
"postal_code": "977014059",
"telephone_number": "541-550-6680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "369 NE REVERE AVE",
"address_2": "SUITE B",
"city": "BEND",
"state": "OR",
"postal_code": "977014059",
"telephone_number": "541-550-6680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURNS",
"first_name": "SUSIE",
"credential": "LMT, NKT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-02-04",
"last_updated": "2011-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "16722",
"primary": true
},
{
"code": "226300000X",
"taxonomy_group": "",
"desc": "Kinesiotherapist",
"state": "OR",
"license": "16722",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASSOCIATED BODYWORK & MASSAGE PEOFESSIONALS",
"identifier": "836868",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OREGON BOARD OF MASSAGE THERAPISTS",
"identifier": "16722",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.